Community nursing is unlike any other nursing specialty. It is unique in that it combines the love of nursing with love for the community.  One must truly have a passion for both nursing and bettering the community to be a community Nurse.  Community Nurses work with patients outside of hospital settings. This poses a challenge for some Nurses.  The community Nurse must be able to work independently, think critically and must rely on resources that are not readily at hand.

Community Nurses can be present in all settings in the community, for example in schools, shelters, non-profit organizations and in food pantries to name a few.  The clinical site at Our Lady of Refuge Church is a food pantry, held every Wednesday in the Church. There my fellow classmates and I experienced community nursing by screening blood pressures and BMIs for the patrons of the food pantry. The following self-reflection narrative will explore how the clinical objectives for this course were fulfilled during the clinical hours at Our Lady of Refuge Church.

Objective 1: Demonstrate individual professionalism through personal behaviors and appearance.

In clinical I demonstrated individual professionalism through my personal behavior and my appearance. I arrived on time to clinical and dressed appropriately in business casual attire as per the department policy. I made sure to come prepared with a watch and my stethoscope. Like my appearance, my behavior was that of a professional nurse. I was actively participant in encouraging patrons to have their blood pressure and BMIs checked. I engaged with the clients and when their pressures were high I initiated teaching to manage hypertension.

Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.

While I enjoyed my experience at the Our Lady of Refuge Church for community

nursing, I did not feel the clinical site allowed for analytical reasoning and critical thinking. Instead the focus was mainly towards the nursing process. Many of the patrons at the site were hypertensive. It was alarming to see how many people were walking around with elevated blood pressures and did not know it. The nursing diagnoses I developed for the patrons were knowledge deficit related to lack of information about the disease process and self-care deficit.  The interventions for the above nursing diagnose included education about foods high in salt,

teaching how to identify such items by reading food labels and teaching the disease process of

hypertension and what the common signs to monitor for example; headache, and

dizziness.  Unfortunately, some of the foods offered at the food pantry are also high in sodium.

Since the food is donated, the church has a limited selection of foods to choose from. An 8 oz.

can of soup offered at the pantry had 870mg of sodium per serving. The patrons are low

income and some have as many as 5 or more family members to feed. Thus, they cannot afford

to refuse an item simply because it’s high in salt. I taught many of the patrons to add water to

help dilute the sodium content in the food. In this way, I could help the client make necessary

modifications to their diet and develop a plan that was specific to their need.

Objective 3: Effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and families in the community setting.

Communication is key in nursing.  Most important to the Nurse is that they can understand their patient and the patient can understand them. The Nurse strives to achieve communication with the patient that is therapeutic and effective. At the clinical site, most the patrons were from Haiti and spoke very little to no English at all. This created a language barrier for our clinical instructor and some of the students. Being that I too am from Haiti, I speak the native language and could translate for my fellow classmates as needed. The people at the pantry are predominately undocumented immigrants and they are not trusting of new comers. Since I speak Creole I was quickly able to gain their trust. I provided teaching on hypertension and foods to avoid in creole and discussed cultural foods high in salt that that they were not aware it would elevate the blood pressure.  Being able to communicate in their native language they were open and forthcoming with me, fostering communication that is both effective and therapeutic.

Objective 4:  Establish environment conducive to learning and use a plan for learners based on evidence-based practice.

Two main health concerns for the people in the East Flatbush community where the church is located is Access to health care and management of hypertension. My assessment of the people at the church pantry was astonishing. Of all the blood pressures my classmates and l checked more than 50% were elevated.  Many of the people there are undocumented, and do not have health insurance. The topic of my group’s service learning project came about because little was known about the health rights of undocumented immigrates. The church did not know where to refer the people there.  Through the service learning project, my group and I were able to find free clinics near the church of which, we will present to the volunteers at the Church pantry to refer as needed to the patrons. The volunteers are close to the clients that frequent the food pantry. They have a bond. The volunteers look out for the frequent patrons and on some occasion, will make home deliveries to them should they be ill and miss a Wednesday. Likewise, the Patrons trust the volunteers. It was necessary to provide teaching to the volunteers, who then in turn could give the information to the clients. Since there was already a relationship there, information on health services for immigrates would be better received from volunteers.

In addition, teaching about evidence based guidelines for the management of high blood pressure in adult were taught; for example, diet management in regards to reducing sodium intake and encouraging exercise, and routine checkups. The Volunteers at the Church are considered Stakeholders to the CHN. They care about the clients at the food pantry and were eager to learn and receive information they could review with the clients. The Church being a place of worship, noise was held to a minimum. Overall the environment was conducive to learning and the volunteers were ready to learn.

Objective 5: Utilize information technology when managing individual and families in the community.

At the Church I checked the patrons’ BMIs. I downloaded an app into my phone to calculates the BMIs after the weight and height are entered. Being able to calculate the BMIs quickly ensured that the patrons did not have to wait long on line and helped to encourage more people to get their BMIs checked as they would otherwise leave if they felt they’d have to wait long. Additionally, one patrons with a Bp reading of 168/88 had stop taking her blood pressure meds because she had recently moved to New York from Florida and had ran out of medication. She had health insurance and simply needed to find a clinic near her new address to follow up. I was able to use my phone to locate three nearby clinics she could attend.  In this way, I employed information technologies to coordinate community care.

Objective 6: Demonstrates a commitment to professional development.

Per Elliot (2010) … to manager the increasing complexity of care and assume greater responsibility in health care, Nurse will need higher levels of education. The nursing disciple has shifted to an evidence base practice. As research provide evident to support better, more efficient ways of doing things, nursing too should evolve. Advancement of the nursing profession is impossible without continuing education. Continued education offers nurses not only the opportunity to learn and improve professionally but personally as well.  Nurses must aim for higher education if they are to provide patient-centered, quality care that is efficient and effective. Furthermore, Nurses must hold higher degrees of education if we are to demand respect for the profession from other disciplines. After my baccalaureate, I plan to advance in the profession by continuing my education in nursing.

Objective 7: Incorporate professional nursing standards and accountability into practice.

In clinical, I adhered to ethical standards, professional nursing codes and upheld standards of care for community- based nursing by maintaining a level of professionalism. I maintain professional by dressing appropriately and arriving to clinical on time each week.  To comply with HIPPA, I protected the patient’s privacy and concealed each patient’s recording and personal information from public view.

In keeping with the nursing code of ethics, Beneficence- to do good and non-maleficence- to do no harm principles, the Nurse owes it to the patient to provide the best possible care for the goal of achieving quality patient outcomes. The only way to do so is to apply practice that is supported by research evidence. Applying evidence to practice ensures that the community Nurse is practicing in a safe and efficient way that of which is owed to every patient supported by truthfulness, another nursing code of ethics.

Objective 8: Collaborate with clients, significant support persons and members of the health care team.

The community nurse collaborates care with other disciplinarians to meet the goals for the patient and optimize the patient’s outcome.  For the service learning project, I set out to find available health services for undocumented immigrates. The information online was limited. I went to Kings Country, there I spoke to a social worker, also I consulted with a case manager at Brookdale hospital to find out services that the people at the pantry could receive for free. I called a few clinics inquiring about services for undocumented people. The information I received I can make referrals to better assist clients to meet their individual goals.

Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.

Since the recent presidential election two health issues affecting the East Flatbush community is the possible termination of the Affordable Care Act and immigration reforms. Affordable care act provides 20 million people with health insurance coverage who may otherwise be without coverage. Lack of coverage hinders primary care and hurts the efforts of the community Nurse. What this means for the community Nurse is that by the time she sees the patient the present of disease will have already exist.

Immigrants in this country are in fear of deportation. They will delay care and may not seek care altogether in hospitals or free clinics. This too, will harm the efforts of the community Nurse.

In conclusion, my experience at the Our Lady of Refugee Church has prepared me for working in the community. I believe Community nursing is unique from any other nursing. Community Nurses area leaders, critical thinkers and are confident to work independently.

 

Reference

Elliott, J., (2010). IOM: Nurses Need More Education, Training. Institute of Medicine. Retrieved November 28^th, 2026 from www.healthleadersmedia.com/nurse-leader/iom.

 

Holzermer, S.P., & Klainberg, M. (2014). Community Health Nursing. An Alliance for Health (2^nd ed). Burlington, MA: Jones & Bartlett, LLC.